SHERELL MARIE SPARKS (NPI# 1538303771) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1538303771 |
| Entity Type | Individual |
| Full Name | SHERELL MARIE SPARKS |
| Credential | M.S., CRC |
| Practice Address |
625 Wham Dr Southern Illinois University Carbondale Carbondale IL 62901-4313 |
| Practice Telephone | 6185362122 |
| Practice Fax Number | 6184537178 |
| Mailing Telephone | 6184537123 |
| Mailing Fax Number | 6184537178 |
| Enumeration Date | 2009-04-30 |
| Last Update Date | 2012-11-26 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YM0800X |
Counselor Specialization: Mental Health |
Behavioral Health & Social Service Providers | ||
| N | 171M00000X | Case Manager/Care Coordinator | Other Service Providers |
| Street Address |
625 WHAM DR SOUTHERN ILLINOIS UNIVERSITY CARBONDALE |
| City | CARBONDALE |
| State | IL |
| Zip Code | 62901-4313 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376917021 | Sarah Kertz | Psychologist | 625 Wham Dr, Room 141, Carbondale, IL 62901-4313 | 2015-11-18 |
| 1891169629 | Chad Drake | Psychologist | 625 Wham Dr, Room 141, Carbondale, IL 62901-4313 | 2015-11-17 |
| 1871965707 | Aseedaw Dea; | Speech-Language Pathologist | 625 Wham Dr, Room 141, Carbondale, IL 62901-4313 | 2015-10-30 |
| 1164656393 | Jenny C Martin | Behavioral Analyst | 625 Wham Dr, Wham 124, Center for Autism Spectrum Disorders, Carbondale, IL 62901-4313 | 2009-05-01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558961268 | Gerad Aaron Harsy | Pharmacist | Walmart Pharmcy, 1450 East Main St, Carbondale, IL 62901 | 2020-10-30 |
| 1437708674 | Board of Trustees of Southern Illinois University | Clinic/Center | 300 W Oak Street, Carbondale, IL 62901 | 2019-09-10 |
| 1306317383 | Rachael O Johnson | Nurse Practitioner | 404 S. Lewis Ln, Carbondale, IL 62901 | 2018-12-17 |
| 1740795194 | Megan Marie Zimmerman | Nurse Practitioner | 1100 W Diann Ln., Carbondale, IL 62901 | 2017-12-07 |
| 1295244242 | Amy Elizabeth Prudencio | Social Worker | 1301 E. Walnut Street, Carbondale, IL 62901 | 2017-09-21 |
| 1740708171 | Theresa Aleise Goodin | Speech-Language Pathologist | 1301 East Walnut Street, Carbondale, IL 62901 | 2017-09-06 |
| 1144762527 | Kathleen Chwalisz Rigney | Psychologist | 306 West Mill Street, Neurorestorative, Carbondale, IL 62901 | 2016-11-16 |
| 1285185173 | Shawnee Health Service and Development Corp | Social Worker | 404 S. Lewis Lane, Carbondale, IL 62901 | 2016-10-17 |
| 1437605094 | Arielle Greer | Nurse's Aide | 510 E. Russell St., A, Carbondale, IL 62901 | 2016-09-01 |
| 1518413863 | Complete Family Eyecare of Carbondale, PC | Optometrist | 1241 East Walnut Street, Carbondale, IL 62901 | 2016-08-28 |
| Find all providers in zip 62901 | ||||
| Taxonomy Code | 101YM0800X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639723109 | Dana Marie Marmo | Counselor | 141 Salem Ave Suite 104, Carbondale, PA 18407 | 2019-08-01 |
| 1043864770 | Kimberly Shahoney | Counselor | 141 Salem Ave Ste 104, Carbondale, PA 18407-2574 | 2019-07-31 |
| 1497309611 | Aaron Best | Counselor | 153 Terrace St, Carbondale, PA 18407-2669 | 2019-07-25 |
| 1942677364 | Elizabeth Salmo | Counselor | 1050 N Reed Station Rd, Carbondale, IL 62902-7376 | 2015-09-02 |
| 1730467218 | Amy Marie Vespa | Counselor | 620 Bridgewater Pl, Carbondale, CO 81623-2185 | 2011-08-01 |
| 1598991929 | Barbara Chambliss | Counselor | 199 Clearwater Rd, Carbondale, CO 81623-1806 | 2009-05-29 |
| 1730329236 | Christopher Abbott Dueker | Counselor | 1082 Cardinal Rd, Carbondale, IL 62901-0735 | 2009-02-24 |
| 1730373523 | Julie A Martin | Counselor | 995 Cowen Dr Unit 203, Carbondale, CO 81623-1657 | 2007-09-05 |
| 1629125208 | Alternative Enterprises, Inc. | Counselor | 606 Eastgate St, Suite A, Carbondale, IL 62901-3304 | 2007-01-04 |
| 1073681821 | Sharmon Elizabeth Frantz-mahoney | Counselor | 6 Narya Trace, Carbondale, IL 62902-7448 | 2006-12-01 |
| Find all providers in CARBONDALE | ||||
| City | CARBONDALE |
| Zip Code | 62901 |
Please comment or provide details below to improve the information on SHERELL MARIE SPARKS.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.